Articulating handle for a deflectable catheter and method therefor

ABSTRACT

A catheter assembly includes a handle assembly, and a catheter body coupled with the handle assembly, where the catheter body extends to a deflectable distal end portion, and the deflectable distal end is controllable by a flexible element. A lever actuator member is operatively coupled with the flexible element, and movement of the actuator member provides for movement of the flexible element.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation-in-part of U.S. patent applicationSer. No. 13/091,187, filed on Apr. 21, 2011, which is a continuation ofU.S. patent application Ser. No. 11/127,818, filed on May 12, 2005, nowU.S. Pat. No. 7,955,314 to Fischer et al., which applications areincorporated by reference herein in their entirety.

FIELD OF THE INVENTION

The present document relates generally to deflectable catheterassemblies. More particularly, it pertains to an articulating handleassembly for a deflectable catheter.

BACKGROUND OF THE INVENTION

Increase in the use of stents, leads, and ablation techniques in branchvessels has provided an increased demand in the placement techniques forthe devices. For some procedures, it is necessary to initially positiona guidewire into a desired part of the lumen of a desired vessel orduct, such as a blood vessel. After the guidewire is positioned withinthe desired location, a catheter or other tubular device may bepositioned over the guidewire and used to convey other medicalinstruments into the desired blood vessel or duct.

Alternatively, a guiding catheter is used to negotiate the vasculatureof a patient. One example of a guiding catheter is described in U.S.Pat. No. 4,898,577 to Badger et al. The Badger guiding catheter includesa single elongate shaft that has a deflectable distal portioncontrollable by a pull wire. Once the distal portion is at the requireddeflection or location within the patient, the medical instrument is fedthrough the catheter.

The deflectable catheter is controlled at a proximal end of the catheterby a control handle that operates the pull wire to deflect the catheter,for example, as shown in U.S. Pat. No. 6,171,277. However, withconventional catheter steering mechanisms, it is sometimes difficult toaccurately position the catheters in certain body vessels, such asbranch veins. For instance, the mechanisms are awkward or require theuse of two hands. Other steering mechanisms require pull wires to bewound and unwound around a rotatable cam wheel, causing increasedfatigue on the pull wires, and potentially shortening the life of thedevice. Furthermore, some deflectable catheters involve relatively largecatheter sheaths. The larger sheaths can be difficult to manipulatewithin a patient, particularly when using a relatively small wheelmechanism or the above-discussed handle assemblies.

What is needed is a deflectable catheter that overcomes the shortcomingsof previous deflectable catheters. What is further needed is adeflectable catheter that allows for more ease positioning of the distalend of the deflectable catheter, and that is usable with a single hand.

SUMMARY OF THE INVENTION

A catheter assembly includes a handle assembly, and a catheter bodycoupled with the handle assembly, where the catheter body extends to adeflectable distal end portion, and the deflectable distal end portionis controllable by a flexible element. The catheter assembly furtherincludes a lever actuator member operatively coupled with the flexibleelement, where the lever actuator member has a first lever position anda second lever position, and movement of the lever actuator memberprovides for movement, of the flexible element and the deflectabledistal end portion. The lever actuator has several options. For example,the lever actuator member can be disposed along a first surface of thehandle assembly, where the lever actuator member is deflectable toward asecond surface when moving from the first position to the secondposition, where the first surface is opposite the second surface. Inanother option, the lever actuator member is movable within a firstplane, and the deflectable distal end portion is movable within a secondplane, and the first plane is substantially non-parallel with the secondplane. Several other options are further discussed below.

A method includes manipulating a catheter assembly, the catheterassembly including a handle assembly, a catheter body coupled with thehandle assembly, the catheter body extending to a deflectable distal endportion, the deflectable distal end portion controllable by a flexibleelement and a lever actuator member mechanically associated with theflexible element, and movement of the lever actuator member provides formovement of the flexible element. The method further includes moving thelever actuator member from a first actuator position to a secondactuator position including moving the lever actuator member from aposition along a first surface of the handle assembly toward a secondopposite surface of the handle assembly, moving the lever actuatormember from the first actuator position deflects the distal end portionof the catheter body.

These and other embodiments, aspects, advantages, and features of thepresent invention will be set forth in part in the description whichfollows, and in part will become apparent to those skilled in the art byreference to the following description of the invention and referenceddrawings or by practice of the invention. The aspects, advantages, andfeatures of the invention are realized and attained by means of theinstrumentalities, procedures, and combinations particularly pointed outin the appended claims and their equivalents.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1A illustrates a perspective view of a catheter assembly asconstructed in accordance with at least one embodiment.

FIG. 1B illustrates a perspective view of a catheter assembly asconstructed in accordance with at least one embodiment.

FIG. 1C illustrates a perspective view of a catheter assembly asconstructed in accordance with at least one embodiment.

FIG. 2 illustrates a side elevational view of a catheter assembly asconstructed in accordance with at least one embodiment.

FIG. 3 illustrates a side elevational view of a catheter assembly asconstructed in accordance with at least one embodiment.

FIG. 4 illustrates a side elevational view of a catheter assembly asconstructed in accordance with at least one embodiment.

FIG. 5 illustrates a side elevational view of a catheter assembly asconstructed in accordance with at least one embodiment.

FIG. 6 illustrates a side elevational view of a catheter assembly asconstructed in accordance with at least one embodiment.

FIG. 7A illustrates a perspective view of a portion of catheter assemblyas constructed in accordance with at least one embodiment.

FIG. 7B illustrates a side elevational view of a portion of a catheterassembly as constructed in accordance with at least one embodiment.

FIG. 7C illustrates a side elevational view of a portion of a catheterassembly as constructed in accordance with at least one embodiment.

FIG. 8A illustrates a perspective view of a catheter assembly asconstructed in accordance with at least one embodiment.

FIG. 8B illustrates that projection 149 deflects the pull wire 120 intoa proximal pull wire segment and a distal pull wire segment formingimaginary proximal and distal acute angles.

FIG. 9 illustrates a perspective view of a portion of a catheterassembly as constructed in accordance with at least one embodiment.

FIG. 10 illustrates a cut-away view of a portion of a catheter assemblyas constructed in accordance with at least one embodiment.

FIG. 11 illustrates a view of a portion of a catheter assembly asconstructed in accordance with at least one embodiment.

DESCRIPTION OF THE EMBODIMENTS

In the following detailed description, reference is made to theaccompanying drawings which form a part hereof, and in which is shown byway of illustration specific embodiments in which the invention may bepracticed. These embodiments are described in sufficient detail toenable those skilled in the art to practice the invention, and it is tobe understood that other embodiments may be utilized and that structuralchanges may be made without departing from the scope of the presentinvention. Therefore, the following detailed description is not to betaken in a limiting sense, and the scope of the present invention isdefined by the appended claims and their equivalents.

A deflectable catheter assembly is disclosed herein and includes ahandle assembly, and a catheter body coupled with the handle assembly,where the catheter body extends to a deflectable distal end portion, andthe deflectable distal end portion is controllable by a flexibleelement. The catheter assembly further includes a lever actuator memberoperatively coupled with the flexible element, where the lever actuatormember has a first lever position and a second lever position, andmovement of the lever actuator member provides for movement of theflexible element and the deflectable distal end portion. The catheterassembly will be described in more detail along with the illustrations.

FIGS. 1A, 1B, and 1C illustrate a deflectable catheter assembly 100,where FIGS. 1A and 1C illustrate the deflectable catheter assembly 100in an articulated position, and FIG. 1B illustrates the deflectablecatheter assembly 100 in an unarticulated position. The deflectablecatheter assembly 100 includes a deflectable catheter body 110 and ahandle assembly 150 that houses steering mechanisms for deflection ofthe catheter body 110. The handle assembly 150, as described in greaterdetail below, allows for the deflection of a distal end of the catheterbody 110. In one option, the pull wire 120 (FIG. 7A) is operablyconnected to a lever actuator assembly that is, for example, rotatedabout a fulcrum to apply tension to the pull wire 120 (FIG. 7A). Astension is applied to the pull wire 120 (FIG. 7A), the pull wire anchorat the distal end of the catheter body 110 is pulled which causes thedistal portion of the catheter body 110 to curve in a predetermineddirection or directions.

The catheter body 110 comprises, in one option, an elongate tubularconstruction that is flexible yet substantially non-compressible alongits length. The deflectable catheter body 110 extends from a proximalend portion 102 to a distal end portion 104, where the distal endportion 104 is disposed within a patient. At the distal end 104 is adistal tip 105. At the proximal end 102, the physician controls thedeflection of the deflectable catheter body 110 with the handle assembly150 and a pull wire 120 (FIG. 7A), as further described below. Thedistal end 104 is deflected to traverse various branch vessels with thecatheter assembly 100.

The catheter body 110 includes a pull wire anchor that is secured to,for example, a distal portion of the catheter body 110. The pull wire120 is mechanically secured to the pull wire anchor, for example, bywelding the pull wire 120 to the pull wire anchor. It should be notedthat the pull wire can be secured to the distal end 104 of the catheterbody 110 in other manners. In one option, the catheter body 110 includesa stiffening member embedded therein, such as a braided stainless steelmember. The stiffening member facilitates rotation of the distal end 104from the proximal end 102, and also assists in preventing the catheterbody 110 from collapsing.

The deflectable catheter body 110 includes a deflectable end portion 104that is deflectable, for example, from a first position, as illustratedin FIG. 1A, to a second position, as illustrated in FIG. 1B. In anotheroption, the second position can be as illustrated in FIG. 10. In atleast one option, the deflection of the catheter body 110 occurs withina first plane. However, it should be noted that the entire device can berotated within the patient during use, for example, while deflecting thedistal end, to access the varying and tortuous vasculature.

Several examples of the handle assembly 150 are shown in FIGS. 2-8. Thehandle assembly 150 extends from a handle distal end to a handleproximal end, and includes a handle assembly longitudinal axis. Thehandle assembly 150 includes a handle housing 152 that is designed toeasily and comfortably fit into a practitioner's hand, and to be easilymanipulated with single handed use. In one option, the handle housing152 are formed of a first portion and a second portion that are coupledtogether, for example, by one or more threaded fasteners. Other devicesand/or methods for coupling the first and second portions of the handlehousing 152 are suitable as well, such as, but not limited to, adhesive,welding, snap-fit, etc.

The handle housing 152 includes a handle lumen 158 therein. The handlelumen 158 is co-operatively aligned or connected with the delivery lumenof the catheter body 110 (FIG. 7A), and the handle lumen 158 (FIG. 7A)extends from a first end to a second end of the housing. The first endof the handle lumen 158, in one option, is disposed proximal to thedistal end of the housing, and the second end of the handle lumen 158,is optionally disposed at the second end of the housing.

The housing 152 and delivery lumen are adapted to receive a medicalinstrument, such as, but not limited to, a guidewire, a lead, anablating device, etc., through the second end of the housing 152. In oneoption, a valve 130 (FIG. 8) is coupled with the delivery lumen of thecatheter body 110 (FIG. 7A). The valve 130 provides further preventionof inadvertent fluid leakage from the delivery lumen. In another option,a fitting such as a luer fitting is provided on or near the housing 152.In yet another option, a side port 132 is coupled with the valve 130,which allows for the valve 130 to be flushed with fluids. The side port132 is disposed through a portion of the handle assembly 150, forexample, through an opening 134, allowing access to the side port 132 bya physician or medical technician. It should be noted that the valve130, the luer fitting, and/or the side port 132 can be combined with anyof the above or below discussed embodiments.

The handle assembly 150 includes therein the actuator assembly 170 thatis operatively coupled with and moves the pull wire 120 (FIG. 7A).Referring to FIG. 7A, the actuator assembly 170 includes an actuator 172disposed through a slot 173 in a first surface 180 of the handle housing152. The actuator 172 is manipulatable by an operator from at least afirst position to a second position to deflect the distal end 104. Inone option, the actuator 172 includes a lever member 174 that is easilymanipulated by a single hand using a squeezing motion. The squeezinginput from the hand is transferred into linear movement to provide thelinear stroke for the pull wire on the proximal end, as furtherdescribed below.

The lever actuator member 174 extends from a first member end 176 (FIG.7A) to a second member end 179 (FIG. 7A), and in one option, isoperatively coupled with the handle assembly 150 at a fulcrum 178 (FIG.7A) or hinge, for example, although not limited to, a lower surface ofthe housing 152. The lever actuator member 174, in at least one option,moves about the fulcrum 178, for example, by a hinge, pivoting, orrotating movement. As the lever actuator member 174 moves about thefulcrum 178, the lever actuator member 174 moves toward a secondopposite surface 182 of the handle housing 152, for example, in to andout of the slot 173 of the housing 152. In another option, the leveractuator member 174 is substantially aligned with a longitudinal axis ofthe handle housing 152 and rotates along the longitudinal axis, forexample, parallel with the housing longitudinal axis.

The lever actuator member 174 is designed to be used by a single handedoperation. For example, the user can squeeze the lever actuator member174 and manipulate the distal end 104 of the catheter assembly. Thelever actuator member 174 is resiliently coupled within the handleassembly such that squeezing the lever actuator member 174 deflects thedistal end 104, for example, in a first direction, and releasing thelever actuator member 174 allows for the resilient member, discussedfurther below, to actuate or deflect the distal end 104 in a seconddirection. Further options which facilitate single-handed operationinclude the relative proportions of the lever actuator member 174. Forexample, the lever extends along the housing where the lever member 174has a length greater than at least half a length of the handle length.

Further options are illustrated in FIGS. 2 to 8A and 8B. FIG. 2illustrates a lever actuator member 174 disposed along an upper surfaceof the housing 152 and an optional grip portion 153 opposite from thelever actuator member 174. The grip portion 153 optionally includesrecesses 155 to receive a user's fingers therein. In another option, asillustrated in FIG. 3, the handle housing 152 has a pistol-grip portion153. In yet another option, which can be incorporated with anyembodiment, the lever actuator member 174 includes a grip portion 153with recesses 155 therein. FIG. 4 illustrates another option where thefulcrum 178 is disposed near the proximal end of the handle housing, andthe lever actuator member 174 moves in and out of an upper surface ofthe handle housing. Opposite the member 174 is the grip portion. 153disposed along the lower portion of handle housing 152.

FIGS. 5 and 6 illustrate additional options for the handle assembly 150.For example, FIG. 5 illustrates a handle assembly 150 with an actuatormember 174 that is moved toward a location within the housing to actuatethe assembly. Linkages 175A, 175B are rotatably coupled with theactuator member 174, allowing for the pull wire to be pulled, and adistal end of the catheter body to be deflected. For instance, a firstlinkage 175A rotates about 171, and is hingedly coupled with theactuator member 174 at 177, for example with a roller 181. The secondlinkage 175B moves with the pull wire 120 along A-A, and is coupled withboth the pull wire 120 and the actuator 174, for instance with one ormore rollers 181. Optionally a spring 183, such as a compression spring,is disposed within the housing and assists in returning the pull wire120 to a predetermined position, such as a J-shape, or a straightposition. As the actuator 174 is moved, the overall linkage lengthextends and retracts, which moves the pull wire 120 relative to thesheath, or catheter body. FIG. 6 illustrates another configuration forthe handle assembly, with similar internal options as discussed abovefor FIG. 5. It should be noted that for both FIG. 5 and FIG. 6 manyother embodiments discussed above and below and be incorporatedtherewith.

The handle assembly 150 further includes an internal mechanism fortranslating the movement of the actuator member 174 to movement of theflexible element, such as, but not limited to, pull wire 120, resultingin deflection of the distal end of the catheter assembly. FIGS. 7A to 7Cillustrate one example. A resilient member 200, such as a spring, isoperably disposed between a lever actuator member 174 and anotherelement, such as the housing 152. The resilient member 200 allows forthe lever actuator member 174 to return to a first position. A linkage190 is disposed within the housing handle 152 and is operatively coupledwith the housing 152 and the lever actuator member 174.

The linkage 190 includes a distal link 192, a proximal link 194, a levermember roller 196, and a handle roller (not numbered). The distal link192 is rotatably coupled with the housing 152 at a first end 193 and isrotatably coupled with the member roller 196 at a second end 195. Theproximal link 194 is coupled with the member roller 196 at a first end191 and with a pull wire assembly 121 at a second end 189. The pull wireassembly 121 moves within a portion of the housing 152 as the levermember actuates the linkage 190. The pull wire assembly 121 ismechanically fixed with the pull wire 120, such that as the pull wireassembly 121 is moved, the pull wire 120 is moved.

FIGS. 7B and 7C illustrate one example of the movement of the internalmechanism that allows for use of the catheter assembly. The leveractuator member 174 is moved from a first position (FIG. 7B) to a secondposition (FIG. 7C), for example, by a user squeezing the lever actuatormember 174, and moves the linkages as illustrated in the figures. Thelinkages 190 move the pull wire assembly 121, and move the pull wire120. As the pull wire 120 is moved, this pulls on the pull wire anchor,and the distal end of the catheter body is deflected into position asdesired by the physician. In at least one option, as the lever actuatoris moved, for example within a first plane of movement, the distal endof the catheter body moves within a second plane of movement.Optionally, the first plane is substantially non-parallel with thesecond plane. In one option, an indicator is associated with themovement, or deflection of the catheter body, such that feedback isprovided while the body is being moved.

FIG. 8A illustrates another option for the internal mechanism. The pull,wire 120 extends through the housing 152 and is anchored to anchor 123.The pull wire 120 is anchored, in one example, at the proximal end tothe anchor 123. The anchor 123 is mechanically fixed, in one option, tothe actuator member 174, where movement of the actuator member 174, forexample around the fulcrum 178, moves the anchor 123 and the pull wire120.

The handle housing 152 includes a projection 149 extending from aninternal portion of the housing 152. The projection 149 obstructs thepath of the pull wire 120 when the pull wire 120 and/or anchor 123 aremoved relative to the projection 149. For example, the actuator member174 is moved from a first position to a second position, and the anchor123 is moved therewith. The anchor movement moves the pull wire 120 andextends it over the projection 149, increasing the amount of pull wire120 disposed within the handle housing 152, and decreasing the amount ofpull wire 120 in the catheter body. This causes tension in the pull wire120 and causes the distal end of the catheter body to deflect. When thelever actuator member 174 is released, the tension in the pull wire 120is released, and the deflection in the distal end is released.

FIG. 8B illustrates that projection 149 deflects the pull wire 120 intoa proximal pull wire segment and a distal pull wire segment. Theprojection 149 is where the pull wire deflects outwardly with respect toan imaginary longitudinal axis A-A extending along the catheter body inan undeflected state from the handle housing 152 to a deflectable distalcatheter portion 104. In that manner, the projection 149 delineates aproximal pull wire segment from a distal pull wire segment, the formerbeing completely proximal of the latter. Moreover, having the proximalpull wire segment being completely proximal of the distal pull wiresegment forms respective imaginary proximal and distal acute angles withrespect to the longitudinal axis A-A. The imaginary proximal acute anglehas the pull wire anchor 123 as a proximal focal point and the imaginarydistal acute angle has the distal pull wire end with any point along thelength of the deflectable distal catheter portion of the catheter body110 (for example, opening 110A) as a distal focal point.

It should be noted that the projection 149 and anchor 123 are oneexample of an internal mechanism where the length of the pull wire 120is displaced; however, other variations are possible. For example, theprojection 149 can be disposed on the lever actuator member 174, and theanchor can be disposed on the housing 152. In another option, theprojection 149 could have a pulley or roller so the pullwire is not,dragged across its surface.

In another option, the handle assembly 150 further includes a lockingmechanism 202 associated therewith, as illustrated in FIGS. 9 to 11, ora locking mechanism 202 associated with the pull wire 220. It should benoted that the locking mechanism 202 or portions thereof can beincorporated with one or more of the various embodiments discussed aboveand below. In one option, the locking mechanism 202 is associated withthe flexible element to lock the flexible element 220 in an intermediateposition. One example of the locking is a mechanism that allows a userto place friction or pressure on the internal mechanisms describedabove, for example, the pull wire assembly. For example, a button orlever disposed along the handle assembly that operably prevents the oneor more of the members of the internal mechanisms from moving.

One example is illustrated in FIGS. 9-11. For instance, a member, suchas knob 210 is received at least partially within the housing 152. Theknob 210 is rotatably coupled with a housing, for example through athreaded connection. A portion of the knob, for example, a distalportion 212, presses the pull wire assembly against a surface within thehousing 152, and prevents movement of the pull wire 220 relative to thehousing 152. For instance, the portion of the knob presses the pullwireassembly 222 against a surface on an opposite side of the pull wireassembly, it should be rioted that other types of locking mechanisms canbe used as well. An example is a locking mechanism that preventsmovement of the pull wire relative to the housing.

The portion 212 can have a larger cross-sectional area than therotatable part of the knob such that additional frictional forces can beplaced on the pull wire assembly. The rotation of the knob 210 causesthe portion 212 to move relative to the pull wire 220; however, theportion 212 may or may not rotate when the knob is rotated. In anotheroption, a high friction member 214 is disposed along portion 212,providing additional frictional forces to the pullwire assembly 222.

In another embodiment, a method comprises manipulating a catheterassembly, the catheter assembly including a handle assembly, a catheterbody controllable by a flexible element coupled with the handleassembly. An actuator member is coupled with the flexible element, wheremovement of the lever actuator member provides for movement of theflexible element and deflection of the distal end. The method includesmoving the lever actuator member from a first actuator position to asecond actuator position. The method further optionally includes movingthe lever actuator member from a position along a first surface of thehandle assembly toward a second opposite surface of the handle assembly,where moving the lever actuator member from the first actuator positiondeflects the distal end portion of the catheter body.

As the lever actuator is moved or manipulated, for example, with onehand, the internal mechanisms are manipulated, as discussed above. Forexample, internal linkages are manipulated, for example, by rotation.Alternatively, the pull wire length is displaced within the housing by aprojection. It should be noted that a combination of these examples arealso possible. Further options include locking the flexible element frommovement, for example, relative to the housing.

Advantageously, the above-described deflectable catheter allows forincreased control of the distal deflectable catheter end. The catheterallows for single-handed use of the device, and allows for a grip forceto be exerted on the handle assembly. A large force can be produced bythe user with grip force, and the device is useful for use with largercatheter shafts or thick-walled catheter shafts which are otherwisedifficult to manipulate, or require a complicated mechanism to multiplyforce of the user.

It is to be understood that the above description is intended to beillustrative, and not restrictive. Many other embodiments will beapparent to those of skill in the art upon reading and understanding theabove description. It should be noted that embodiments discussed indifferent portions of the description or referred to in differentdrawings can be combined to form additional embodiments of the presentinvention. The scope of the invention should, therefore, be determinedwith reference to the appended claims, along with the full scope ofequivalents to which such claims are entitled.

What is claimed is:
 1. A catheter assembly, comprising: a) a handlehousing; b) a lever actuator member pivotably coupled to the handlehousing; c) a projection providing a projection surface extendingoutwardly from an internal portion of the handle housing; d) a pull wireanchor fixed to the lever actuator member at a proximal location withrespect to the projection; e) a catheter body extending, in anundeflected state, distally along a longitudinal axis from the handlehousing to a deflectable distal catheter portion; f) a pull wireextending along the longitudinal axis from a proximal pull wire endfixed to the pull wire anchor in the handle housing to a distal pullwire end at the deflectable distal catheter portion, i) wherein theprojection surface contacts the pull wire and is where the pull wiredeflects outwardly with respect to the longitudinal axis and delineatesa proximal pull wire segment from a distal pull wire segment, and ii)wherein the proximal pull wire segment is completely proximal of thedistal pull wire segment; and g) the lever actuator member including thepull wire anchor fixed thereto being movable with respect to theprojection surface of the projection from a first lever position to asecond lever position, wherein: i) in the first lever position, theproximal pull wire segment is a first initial length and the distal pullwire segment is a second initial length; and ii) in the second leverposition, the proximal pull wire segment is of a first greater lengththan the first initial length and the distal pull wire segment is of asecond lesser length than the second initial length to thereby createtension in the pull wire that acts to deflect the distal catheterportion of the catheter body, and iii) wherein movement of the leveractuator member causes the proximal and distal pull wire segments toassume their respective first greater length and second lesser lengthwhile continuing to extend along the longitudinal axis with the proximalpull wire segment remaining completely more proximal than the distalpull wire segment.
 2. The catheter assembly of claim 1 wherein the leveractuator member is configured to displace at least one of the pull wireanchor or the projection to increase the length of the proximal pullwire segment disposed within the handle housing and decrease the lengthof the distal pull wire segment extending from the projection to thedeflectable distal end portion of the catheter body.
 3. The catheterassembly of claim 1 wherein the handle assembly is configured forsingle-handed manipulation.
 4. The catheter assembly of claim 1 whereinthe pull wire anchor disposed within the handle assembly is fixedlycoupled to the lever actuator member.
 5. The catheter assembly of claim1 wherein the projection disposed within the handle housing is fixedlycoupled to the lever actuator member.
 6. The catheter assembly of claim1 wherein the projection disposed within the handle housing includes aroller, the roller being movably coupled to the pull wire.
 7. Thecatheter assembly of claim 1 wherein the tension created in the pullwire as a result of movement of the lever actuator member isproportional to the increase in length of the first greater length tothe first initial length or the decrease in length of the second lesserlength to the second initial length.
 8. The catheter assembly of claim 1wherein the pull wire is in a slidable relationship with the projectioncontact surface.
 9. The catheter assembly of claim 1 wherein theproximal pull wire segment being completely proximal of the distal pullwire segment forms respective imaginary proximal and distal acute angleswith respect to the longitudinal axis, the imaginary proximal acuteangle having the pull wire anchor as a proximal focal point and theimaginary distal acute angle having the distal pull wire end at thedeflectable distal catheter portion of the catheter body as a distalfocal point.
 10. A catheter assembly, comprising: a) a handle housing;b) a lever actuator member pivotably coupled to the handle housing andbeing continuously variable from a first lever position to a secondlever position; c) a projection providing a projection surface extendingoutwardly from an internal portion of at least one of the handle housingor the lever actuator; d) a pull wire anchor fixed to the lever actuatormember at a proximal location with respect to the projection; e) acatheter body extending, in an undeflected state, distally along alongitudinal axis from the handle housing to a deflectable distalcatheter portion; f) a pull wire extending along the longitudinal axisfrom a proximal pull wire end fixed to the pull wire anchor in thehandle housing to a distal pull wire end at the deflectable distalcatheter portion, i) wherein the projection surface contacts the pullwire and is where the pull wire deflects outwardly with respect to thelongitudinal axis and delineates a proximal pull wire segment from adistal pull wire segment, and ii) wherein the proximal pull wire segmentis completely proximal of the distal pull wire segment; and g) the leveractuator member including the pull wire anchor fixed thereto beingmovable with respect to the projection surface of the projection from afirst lever position to a second lever position, wherein: i) in thefirst lever position, the proximal pull wire segment is a first initiallength and the distal pull wire segment is a second initial length; andii) in the second lever position, the proximal pull wire segment is of afirst greater length than the first initial length and the distal pullwire segment is of a second lesser length than the second initial lengthto thereby create tension in the pull wire that acts to deflect thedistal catheter portion of the catheter body, and iii) wherein movementof the lever actuator member causes the proximal and distal pull wiresegments to assume their respective first greater length and secondlesser length while continuing to extend along the longitudinal axiswith the proximal pull wire segment remaining completely more proximalthan the distal pull wire segment.
 11. The catheter assembly of claim 10wherein the lever actuator member is configured to displace at least oneof the anchor or the projection to increase the proximal pull wiresegment disposed within the handle housing from the first initial lengthto the first greater length.
 12. The catheter assembly of claim 10wherein the projection disposed within the handle housing includes aroller, the roller movably coupled to the pull wire.
 13. The catheterassembly of claim 10 wherein the lever actuator member is configured todisplace at least one of the pull wire anchor or the projection toincrease the length of the pull wire proximal segment from the firstinitial length to the first greater length.
 14. The catheter assembly ofclaim 10 wherein the handle assembly is configured to receive a gripforce.
 15. The catheter assembly of claim 10 wherein the projectionextends from an internal portion of the handle housing; and wherein thepull wire anchor is fixedly coupled to the lever actuator member. 16.The catheter assembly of claim 10 wherein the projection extends from aninternal portion of the lever actuator member; and wherein the pull wireanchor is fixedly coupled to the handle housing.
 17. The catheterassembly of claim 10 wherein the lever actuator member is operativelycoupled to the handle assembly at a fulcrum.
 18. The catheter assemblyof claim 10 including a locking mechanism associated with thedeflectable distal end portion of the catheter body to secure thedeflectable distal end portion in an intermediate position between thedistal portion first position and the distal portion second position.19. The catheter assembly of claim 10 wherein the deflectable distal endportion is displaced from the distal portion first position toward thedistal portion second position by an amount proportional to adisplacement of the lever actuator member.
 20. The catheter assembly ofclaim 10 wherein the proximal pull wire segment being completelyproximal of the distal pull wire segment forms respective imaginaryproximal and distal acute angles with respect to the longitudinal axis,the imaginary proximal acute angle having the pull wire anchor as aproximal focal point and the imaginary distal acute angle having thedistal pull wire end at the deflectable distal catheter portion of thecatheter body as a distal focal point.